Section 410 IAC 16.2-3.1-18 - Infection control programAuthority: IC 16-28-1-7
Affected: IC 16-28-5-1
Sec. 18.
(a) The facility must establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of diseases and infection.(b) The facility must establish an infection control program under which it does the following: (1) Investigates, controls, and prevents infections in the facility, including, but not limited to, a surveillance system to:(A) monitor, investigate, document, and analyze the occurrence of nosocomial infection;(B) recommend corrective action; and(C) review findings at least quarterly. The system shall enable the facility to analyze clusters and/or significant increases in the rate of infection.
(2) Decides what procedures (such as isolation) should be applied to an individual resident, including, but not limited to, written, current infection control program policies and procedures for an isolation/precautions system to prevent the spread of infection that isolates the infectious agent and includes full implementation of universal precautions.(3) Maintains a record of incidents and corrective actions related to infections.(4) Provides orientation and in-service education on infection prevention and control, including universal precautions.(5) Provides a resident health program, including, but not limited to, appropriate personal hygiene and immunization.(6) Provides an employee health program, including appropriate handling of an infected employee as well as employee exposure.(7) Reports communicable disease to public health authorities.(c) A diagnostic chest x-ray completed no more than six (6) months prior to admission shall be required.(d) Prior to admission, each resident shall be required to have a health assessment, including history of significant past or present infectious diseases and a statement that the resident shows no evidence of tuberculosis in an infectious stage as verified upon admission and yearly thereafter.(e) In addition, a tuberculin skin test shall be completed within three (3) months prior to admission or upon admission and read at forty-eight (48) to seventy-two (72) hours. The result shall be recorded in millimeters of induration with the date given, date read, and by whom administered and read.(f) The baseline tuberculin skin testing should employ the two-step method. For residents who have not had a documented negative tuberculin skin test result during the preceding twelve (12) months, the baseline tuberculin skin testing should employ the two-step method. If the first step is negative, a second test should be performed within one (1) to three (3) weeks after the first test. The frequency of repeat testing will depend on the risk of infection with tuberculosis.(g) All residents who have a positive reaction to the tuberculin skin test shall be required to have a chest x-ray and other physical and laboratory examinations in order to complete a diagnosis.(h) All skin testing for tuberculosis shall be done using the Mantoux method (5 TU PPD) administered by persons having documentation of training from a department-approved course of instruction in intradermal tuberculin skin testing, reading, and recording.(i) Persons with a documented history of a positive tuberculin skin test, adequate treatment for disease, or preventive therapy for infection, shall be exempt from further skin testing. In lieu of a tuberculin skin test, these persons should have an annual risk assessment for the development of symptoms suggestive of tuberculosis, including, but not limited to, cough, fever, night sweats, and weight loss. If symptoms are present, the individual shall be evaluated immediately with a chest x-ray.(j) When the infection control program determines that a resident needs isolation to prevent the spread of infection, the facility must isolate the resident only to the degree needed to isolate the infecting organism.(k) The facility must prohibit employees with a communicable disease or infected skin lesions from direct contact with residents or their food if direct contact will transmit the disease. An employee with signs and symptoms of a communicable disease, including, but not limited to, an infected or draining skin lesion shall be handled according to a facility's policy regarding direct contact with residents, their food, or resident care items until the condition is resolved. Persons with suspected or proven active tuberculosis will not be permitted to work until determined to be noninfectious and documentation is provided for the employee record.(l) The facility must require staff to wash their hands after each direct resident contact for which hand washing is indicated by accepted professional practice.(m) For purposes of IC 16-28-5-1, a breach of:(1) subsection (a) is an offense;(2) subsection (b)(1), (b)(2), (j), (k), or (l) is a deficiency; and(3) subsection (b)(3), (c), (d), (e), (f), (g), (h), or (i) is a noncompliance.Indiana State Department of Health; 410 IAC 16.2-3.1-18; filed Jan 10, 1997, 4:00 p.m.: 20 IR 1542, eff Apr 1, 1997; readopted filed Jul 11, 2001, 2:23 p.m.: 24 IR 4234; readopted filed May 22, 2007, 1:44 p.m.: 20070613-IR-410070141RFA; readopted filed Sep 11, 2013, 3:19 p.m.: 20131009-IR-410130346RFAReadopted filed 11/13/2019, 3:14 p.m.: 20191211-IR-410190391RFA